The Cervical Intervertebral Foramen: Microanatomy, Pathology, and Clinical Implications.

Clin Spine Surg · Apr 01 2025 · Review

Caballero JJ, Darden A, Ahmad S, Boody B

Indiana Spine Group, Carmel, IN

Spine

SUMMARY — THE REDUCTIONNarrative review of cervical intervertebral foramen microanatomy, dynamic size changes, and degenerative pathology, aimed at helping clinicians better understand and treat nerve root compression and cervical radiculopathy.
Abstract, as published

OBJECTIVE: We hope to provide a primer on cervical intervertebral foramen (cIVF) anatomy for spine surgeons, interventionalists, and physiatrists who regularly treat cervical spine pathology, and encourage further exploration of this topic.

BACKGROUND: This corridor for exiting cervical nerve roots is characterized by its intricate microanatomy involving ligamentous, nervous, and vascular structures. Degenerative changes such as facet hypertrophy and disc herniations alter these relationships, potentially leading to nerve root compression and cervical radiculopathy.

METHODS: This review synthesizes existing knowledge on the cIVF. Key imaging, cadaveric, and clinical studies serve as a foundation for this anatomic review.

RESULTS: We explore topics such as dynamic changes that affect foraminal size and their implications for nerve root compression, the relationship of the dorsal root ganglion to the cervical foramen, and the function and clinical significance of foraminal ligaments, arteries, and veins.

CONCLUSIONS: Changes in the cIVF are frequently the basis of cervical degenerative pathologies. A comprehensive understanding of its microanatomical structure will allow the practitioner to better treat the underlying disease process causing their symptoms and signs.

STUDY DESIGN: This is an evidence-based narrative review article.

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